14 posts tagged “clinicals”

I went to school for my CBI checkoff at 1:30. My clinical instructor, Jessica, was there so she said that she would take me. I told her that I am less comfortable with this skill than any other skill this semester. So she did a demonstration of all three types of bladder irrigation for me. Now this was good because after the demonstration I realized that I had no idea what was expected of me for that skill. This was bad because if you get a demonstration from an instructor, you can't be checked off that same day. I had to sign up for another time on Thursday morning before the final review. That's okay, I guess.

I came home and took a nap for an hour or so. I decided to get Taylor when I woke up at 4:45 because I didn't want to have to get up again to pick her up before 6. On the way home I checked my voice mail and I had one from Jessica asking me to call her about my CARP assignment. She said that it had to be emailed today or else I would have an incomplete for my clinical course. Sigh...I had planned on doing it tonight or tomorrow, although I knew I really should send it in today. So when I got home, instead of going back to sleep I sat down and did my paper. It's not my best work, but I'm pretty happy with it.

I've also done some HESI modules to prepare for the HESI exam tomorrow morning. I'm going to do a few more after I figure out what to make for dinner.

I really, really need a nap. Although I took one yesterday, I went to bed pretty late last night and have more or less been awake since 6:45 this morning (I slept in between hitting the snooze bar until 7:45 or so). I had my Final Evaluation for Clinicals this morning at 8:20. I passed, of course, and my instructor had some very nice things to say about me. The only weakness she mentioned was PIE charting, as I (and most of my class) forget to document the evaluation part if it's only something like 'patient understood instruction' blah blah.

Anyway. At 1:30 I have a checkoff in skills lab for Continuous Bladder Irrigation, which is why I'm not sleeping right now. I still have to read/learn it right quick before I go.

Also today I have to study for my HESI exam tomorrow and I really should write my IPR that is kinda due today (kinda in that the prof said to turn it in "next week" last Tuesday, but my syllabus says it's due a week after you go to CARP). Whatever. I just want to nap.

I cannot even describe how little I want to go to CARP tomorrow. I forget what it stands for, but it's basically a substance abuse treatment center. I am sorry, but I have dealt with enough substance abusers in my life. Enough for two lives, maybe.

While I am there I will converse with a patient, give "therapeutic" responses, and after I leave I will write a paper detailing our conversation in verbatim, with side notes about which category of "therapeutic responses" my feeble replies fall into. If I decide I wasn't appropriately helpful, I can then detail which response I *should* have given instead. It is a giant fucking pain in the ass, and quite possibly one of the LAST things I would do in this world, given the choice.

Listen, I have all the respect in the world for people who have addictions, admit that, and seek help. But I have to admit that my viewpoint is colored by the addicts I have known who haven't.

I don't have a lot of time to write this entry, but I just wanted to say that I got to observe in the Cardiac Cath Lab today and I really liked it! Basically, a catheter is inserted into the femoral artery in the groin. From there it is threaded up to the heart where contrast dye is released so that the coronary blood vessels are visible. It is so cool. This is about what it looks like:

I alternated between standing in the room where the procedure was going on, and the room beyond the glass where the recording nurse sits. That person keeps an eye on the heart monitor and also records the procedure log. Here is what the image looks like:

So you can't really see the *heart* but you can see all the vessels surrounding it and pulsating. I can't explain to you how interesting this was to me. I'm just so jazzed up by this experience. I got to see 3 procedures done in the 4 hours I was there. I was lucky, it was a busy day.

Anyhow, got to get ready to take the train down to Alex's. He's picking me up on the bike. Woohoo!

Yay! I got the Nurse Extern Job!

Boo: It pays less than I thought. A couple other hospitals are paying $15/hr. This job will pay me $10/hr for part-time, $12/hr if I am per diem. Basically if I'm per diem, I can say, "Nah, don't feel like working", and in turn they can say, "Nah, we don't need you to work today." The woman in HR said that I will still be scheduled for my two days, but if they are not busy, per diems are the firs to be sent home. I will be doing per diem. I'll take the chance for 20% more on my check.

Yay! I will be doing CNA duties, along with skills I am learning in school. They also may have me helping out the charge nurse as a unit clerk, and I was told I could take the Beginning EKG Interpretation class and then take my test to be a monitor tech as well.

The past two days I have been doing my rotation as Client Care Manager at clinicals. This means I've had to get to the hospital at 6:30 am (an hour early). And right after the time change too! Super. Basically, I was not assigned patients. Instead I helped assign patients to my classmates and then checked in with them throughout the day to get updates on their patients and help them develop ideas for their careplans and documentation. There's a bit more to it than that, but you get the gist. Now instead of doing the paperwork I normally do each week on one of my patients, I have to write a short paper on my experience. You know I'm doing that shit Sunday night.

Anywhos, I am BEAT. Sunday night I couldn't get to sleep until after midnight, and then I woke up at 2am with poopy cramps. My alarm went off at 5am. I need to go sleepy nie nies now.  

I got a 92% on my test today! Awoohoo! Much as I hate to admit it, I think it might have something to do with all those required practice modules we had to do before this test. We had to complete 50% of the term requirement or we weren't allowed into the test. This brings my average up to 87.3%, 2.7% away from an A. That would be so awesome; this class is worth 7 credits.

Midterm evals for clinicals are on Monday. I'm not really worried about that. My teacher already said that my paperwork is great. I'm not saying that she won't have any suggestions for improvement, and actually I hope she does. I am gaining a lot of skill and confidence in this rotation and any constructive criticism is only going to further my competence.

In other news, Alex wants me to go to the doctor because I took my temp yesterday and it was 100.1F which means that I've basically been running a fever for almost 2 weeks now and I am just exhausted, even when I get a good night's sleep. I don't disagree with him but I don't have insurance now so it's going to cost me money I'd rather not spend. He does have a reasonable doctor who is very non-insured friendly, but it's down by him. He wants me to call and make an appointment today, even if it's not until next week. I am not sure why I am resisting this as much as I am. I can't function when I am this tired all the time. My life is exhausting as it is without adding a sickness to it. I just hope it's not something nasty I picked up in clinicals. I wouldn't think so, I'm pretty good about washing my hands upon entering and leaving patients' rooms. This week I had the same patient Monday and Tuesday. Tuesday they put him on contact precautions because his lab results came back positive for C. Diff. My first thought was, "Crap, I wish I had taken his vitals first," because you can't take dynamaps in isolation rooms so I had to take manual BP, use a disposable thermometer, and wipe my steth down completely with alcohol after I was done. My second thought was, "Great. He wasn't on contact YESTERDAY when I was in his room all day." Honestly, I'm not that worried because the organism is in his poop and you know I wasn't touching any of that.

Well I suppose I ought to get back to work. I only have 4 days left here, including today. Which reminds me, I seriously need to update my resume tonight.

I am so freaking tired! I know, this is nothing new for me but I've actually been getting a good amount of sleep this week. Tuesday night I got 12+ hours, Wed I got...maybe 6 or so (which is less than I prefer) but then last night I got 8 so I don't know why I feel like my head is about to fall onto my keyboard.

Except perhaps that I've been sick for a week. I don't know if I've continued to run a fever because I haven't taken my temp since Tuesday AM when it was 101F. I'm just not giving my body enough chance to recharge, I suppose, and I won't in the near future either. I would love to go home tonight and just go right to bed but I have too much stuff to get done.

I have a test on Wednesday and we have to show proof that we've completed half of the course requirements in the HESI and MedsPub modules or else they don't even let you take the test. HESI I can deal with. They say, complete 8 modules. MedsPub says, "Complete 90 minutes in this section", which is stupid. Last night I signed on and then let the annoying voiced lady talk while I cleaned up the computer room (which is such a welcome improvement. It was a shithole.). When she finished one page, I'd click to the next, and in that way I got a lot of the required time out of the way. I still need to study for the actual test too.

This weekend is going to be busy.
Saturday:
8:30-11:30am Skills Lab Class (and check off on CVL flushing and dressing change which I have to study for tonight)
1:30pm-?? My grandmother's 80th birthday party
7:30pm-?? Monster truck show at the stadium (I'm excited! Alex got the tickets free from work and I've never been to one before so it should be fun!)

Sunday Alex has his motorcycle class from 7am-3pm I think, so I shall sleep, study, and go see my grammie somewhere in there since she is selling her condo and they close on Wednesday. :( Oh and I also have to do my paperwork for clinicals on Monday.

I just. need. to SLEEEEEEEEEP.

Seriously. I feel like I'm going to fall over.

My Nurse's Notes for today:

0800- sitting up in bed 35 degrees watching TV.  Resting comfortably, no resp distress noted. t 98.8 p 94 bp 160/72 rr 18 O2 sat = 96% on room air.  changed diaper, loose stool present.  noted redness and irritation on gluteal folds and scrotum.  reapplied condom catheter.  left pt w/ call bell in reach, bed rails up x2.

1000- changed diaper, loose stool present.  applied zinc ointment to reddened areas of gluteal folds and scrotum.  pt expressed pain when cleaning fecal matter from area.  condom catheter came off so a new one was applied.  catheter tubing secured to leg with paper tape.

And how was your day?   In all honesty it wasn't that bad.  This is the first time I've actually had to clean poo since I've been in nursing school and my luck was bound to run out eventually.  What was really a pain was having a patient who was on contact precautions because of MRSA (methicillin resistant staph infection) in a wound on his toe.  That means I had to wear a gown and glove for all patient contact.  Gets hot after awhile and you have to take it off when you leave the room and then put a new one on.  Ah well, another day, more knowledge put into my brain.

Also, I got a call from the HCA scholarship coordinator at my school who wants me to come in for an interview tomorrow, so wish me luck with that!  My biggest hurdle is that I'm requesting an out-of-county hospital, so I have to be approved by that district.

I have clinicals at the VA hospital this term. Yesterday was orientation, so we had to read these big booklets on safety procedures, injury prevention, policies, blah blah blah. That's pretty standard. We had to sign some forms saying that we read the books and understood them, also standard. What is NOT standard is the MOUNTAIN of paperwork we had to do after that. Seriously, form after form after form. That was yesterday.

Today we got fingerprinted. There are 10 of us. We got there at 8am. They finally finished the last students at 12:30. Meaning, the remainder of the time we sat there with our thumbs in our bums with nothing to do. I cannot stand when my time is wasted like that. Oh, and we're still not done! Apparently we also need to be given computer access (maybe, they still haven't decided).

And you would think that a hospital so security conscious would want to issue us ID badges, but you would be wrong. This means that we can't administer meds without the floor nurse in the room with us. Oh wait till they find out, I'm sure they will be so thrilled that they have to babysit us putting pills in a cup even though our instructor is a licensed RN.

Bah. Gotta love government hospitals

Today was Semester II orientation. I found out that I am doing clinicals at the VA Hospital. This is sucky for a couple reasons: no one from my old clinical group is there, and it's all the way in Palm Beach Gardens (at least a half hour away and that's with NOOOOOOO traffic on 95). As for the VA itself, I've heard both good things and bad, so I guess we'll see. Unfortunately I'm not working in this area after graduation, because I've heard good things about being a VA nurse. Although they don't have OB anyway, so I guess that wouldn't work.

I printed out the syllabus for each of my classes and started skimming through them. Not really a good idea. All that does is freak me out looking how much I have to accomplish in the next four months. Chest tubes and ostomy care? Ewwww. I also found out that I will rotate to a detox center for one day, and I will also have a shift where I act as the Charge Nurse(?) and head up the team of student nurses. Everyone gets a turn at this.

I will have 6 exams this semester before my MedSurg HESI and my final exam. A couple papers due for clinicals (same as last term, IPR, CHAT, DHAT) except we are expected to be more thorough this time.

Today I need to:
Take down the Christmas tree so it can go out with the trash in the morning

Tomorrow I need to:
Buy a couple books and sell my books from last term
Clean out my notebooks and/or buy new ones for this semester

This weekend I need to:
Assemble my clinical supplies
Wash and iron my uniforms
Start reading
(maybe)Do a VA runthrough so I have some idea how to find the lobby